Tuesday, October 18, 2011

Muscles and cranial function: The applied kinesiology advantage in cranial therapy

 
Nearly everyone who has done an in-depth study of natural health recognizes that the body in general is a self-correcting, self-maintaining mechanism designed to maintain or regain health. It is usually when trauma, nutritional deficiency, stress, or something else occurs to the body that it can no longer carry out this function.

Whiplash Injuries Are A Common
Source of Cranial and Cranial Muscle Injury

An excellent example of the body correcting itself is seen in the cranial-sacral primary respiratory mechanism. Normally, every time an individual chews, swallows, yawns, or takes a deep breath, the cranium receives a treatment. Almost everyone develops cranial faults at some time throughout the day. A fault may result from leaning the face on a propped-up hand while reading at a desk, from facial and cranial pressures during sleep, wearing certain types of headgear (such as a welder's helmet), or from bumps and jars. Not only do cranial faults that disturb normal nerve function develop, but there is mechanical misalignment of the skull.

The head is so important to human function that elaboration of its importance may seem unnecessary. Craniosacral, applied kinesiology, and sacro-occipital concepts and research have emerged which place dysfunction of the bones of the skull, its sutures and internal fascial structures (dura, reciprocal tension membranes, etc.), as well as the circulation of blood, lymph and the cerebral spinal fluid that passes through the brain and its open spaces, at the center of many health problems.


Leon Chaitow (2005)
Before treating any apparent cranial dysfunction, attention should be given to soft tissue changes, muscle and fascia, which could for example be impacting upon cranial suture mobility. Treatment of all the weak or hypertonic muscles that attach to the cranial and facial structures is essential prior to any attempt at treating the osseous structures themselves, including the dentition in cases of malocclusion or temporomandibular joint disorders.

Silverman (1973) recognized the mechanical misalignment factors of the skull by evaluating his own occlusion. He did this by two methods that enabled him to evaluate it at any time. First, when the teeth contact in an ideal centric occlusion, there is an audible, sharp, staccato-like sound. This can be measured objectively by a phonocardiogram, (1976) with the microphone placed on the cheek. One can feel that sharp contact when there is no malocclusion. Second, when the teeth are forcefully brought together and then very lightly tapped repeatedly, there should be a direct route to full intercuspation. When there is malocclusion, there is a very light premature contact and then the mandible slides into full intercuspation, which can be felt by a sensitive individual.

Silverman observed that upon awakening, he sometimes had a deflective prematurity which would last from several minutes to over an hour. The deviation from normal was usually corrected after eating breakfast. Further observation revealed no malocclusion when he awakened from sleeping on his back, but there was malocclusion when waking from sleeping on his stomach with his face mashed into a pillow.

Silverman continued this investigation and found several factors that could immediately return his occlusion to normal, including taking a deep breath, swallowing, chewing, and other activities of normal physiology. After recognizing the effects of sleeping positions on his occlusion, Silverman investigated other factors that might cause temporary changes in occlusion. These included forces on the face, such as that already mentioned of propping the face on hand while reading, head placed in the older type "V" dental headrest, wide excursive movements with the mandible (either laterally or wide open such as is often done in dental procedures), and forcefully blowing the nose.

Sensory abilities include proprioception and exteroception (vision, vestibular apparatus and audition), and come significantly from organs housed in the skull. In the case of the eyes and their tracking movements, applied kinesiology cranial approaches can be beneficial. These exteroceptive sensory contributions should not be underestimated and their losses should be considered in the overall management of the patient. (Cuthbert & Barras, 2009; Cuthbert & Blum, 2005)

The sphenoid bone's torsion cranial fault -- one
of the most difficult and complicated cranial
dysfunctions to diagnose and correct --
is made far easier with AK cranial challenge and treatment.




These are just some examples of how cranial faults might develop throughout the day, and how the normal physiology of chewing, swallowing, yawning, and deep inspiration can correct them. For these corrections to take place, it is necessary for normal occlusion and normal muscle action to be present prior to the temporarily created cranial fault. The corrections are obtained during swallowing, chewing, and yawning by the muscles of mastication pulling on their insertion at the levers of the cranium, which include the zygomatic and pterygoid processes. In addition, there are wide contacts of muscles, such as the temporalis, which produce a bilateral, even movement to the skull during swallowing.

THE IMPORTANCE OF MUSCLES FOR SELF-CORRECTING CRANIAL FUNCTION

The influence of muscles upon cranial function is very critical, and for this reason the applied kinesiology examination and treatment of the cranial-sacral mechanism excels over most other methods of diagnosis and treatment. AK examination determines the strength and/or weakness of the individual muscles that attach to the skull; the vast number of treatment approaches in AK for these disorders of specific muscles is the reason AK treatment is so effective in cases of cranial dysfunction.

The two temporalis muscles are directly connected to the temporal bones (fossa and squama), the parietals (squama), the greater wings of the sphenoid. and the posterolateral aspects of the frontal bones, crossing the coronal sutures, the sphenosquamus sutures, and the temporoparietal sutures. It is hard to imagine muscles with greater direct mechanical influence on cranial function than these thick and powerful structures.

Upledger and Veredevoogd (1983) point out that when the teeth are tightly clenched, contraction of the temporalis draws the parietal bones down. Because of the architecture of the squamous suture between the temporal bone and the parietal bone, a degree of sliding is possible is between them. Prolonged crowding of the suture (resulting from dental malocclusion, anger, tension, trauma, etc.) can lead to ischemic changes as well as pain locally and at a distance. Subsequent influences might involve the sagittal sinus and possibly CSF resorption, including dysfunction at the jugular foramen with implications for the spinal accessory nerve, thereby increasing the trapezius muscle's dysfunction, unleveling the head, affecting the vagus nerve to the digestive tract, and the stability of the cervical joints which this muscle (as well as the sternocleidomastoid, also innervated by the spinal accessory nerve) controls. Upledger and Veredevoogd (1983) report that such a scenario can lead to mild to moderate cerebral ischemia which is reversible.

Trigger points from the temporalis muscle refer to the side and the front of the head, eyebrows, behind the eye and upper teeth, as well as the TMJ. The temporalis muscle lies in the referred pain zone from myofascial trigger points of several cervical muscles, including trapezius and sternocleidomastoid, and its trigger points may be satellites of trigger points in these muscles. (Simons et al, 1998) These important muscular attachments to the head emphasize the profound influences of muscular function to the cranium.



Temporalis muscle and movement -- essential
to normalize in cases of TMD



Lateral pterygoid muscle's myofascial trigger point
and its referred pain pattern. MANY head
pains are REFERRED muscle pains.
Differentiating these two conditions
can be accurately done with AK technique.

Travell and Simons (1983) state, “The external (lateral) pterygoid muscle is frequently the key to understanding and managing TMJ dysfunction syndrome and related cranial mandibular disorders”. Upledger and Veredevoogd (1983) confirm this. “It (lateral pterygoid) is a frequent cause of recurrent cranial sacral and temporal mandibular joint problems”. The medial pterygoid can interfere with sphenoid function, with the maxilla's movement and with normal motion of the palatine bones. It is commonly involved in TMJ problems. Trigger points in this muscle (easily identified with AK testing methods) can produce restrictions in the ability to fully open the jaw, sore throat and swallowing difficulties, as well as TMJ pain. Along with other key muscles of the region, assessment and (if needed) therapeutic attention to the temporalis, lateral and medial pterygoid muscles is a pre-requisite of lasting and successful cranial sacral therapy.

Medial pterygoid treatment essential to successful
resolution of TMD

MUSCULATURE OF THE SOFT PALATE

The levator veli and tensor veli palatini muscles both attach to the auditory tube. Their primary role appears to be to open the entrance to the auditory tube in order to equalize air-pressure during swallowing. Inhibition or hypertonicity in this muscle has important clinical meaning as the auditory tube, which when open may provide an easy passageway for oro respiratory tract infections to reach the middle ear. 

Ear infections in young children and their relationship with tensor veli palatini muscle imbalance and trigger points is an area deserving of clinical research. Since these infections readily occur in young children who are in a chronic sucking state (thumbs, fingers, pacifiers, toys, nipple of the bottle or breast), the association of the tensor veli palatini seems obvious and deserves consideration. In our experience, eustachian tube dysfunction is the most common cause of otitis media and this can be the result of fixation of the temporal bone. Cuthbert and Rosner (2010) reported the successful treatment of a 6-year old girl who had painful ear aches (and antibiotic treatment) on a monthly basis since she was 4-months old.
Cranial disorders are particularly disturbing for young children
with repeated ear infections.
AK cranial treatments are effective for these infants!
(See Applied Kinesiology Meets the Health Care Needs of Children Blog Entry.
http://drscottschat.blogspot.com/2010/12/applied-kinesiology-and-health-care.html)

It is fortunate that the body has self-correcting mechanisms that are in keeping with the overall design of the body to be self-correcting and self-maintaining. Unfortunately, problems sometimes develop in which these normally corrective mechanisms produce and maintain cranial faults. If there is a prematurity artificially produced by improper equilibration of dental prostheses, the muscular forces into the skull are imbalanced and create the cranial fault rather than correcting it. The muscles of mastication can also become hypertonic on one side, causing an imbalanced pull into the cranium.

Fortunately, applied kinesiology techniques can determine when there is an imbalance of muscles or an occlusion creating cranial faults. This evaluation capability is one of the factors that has helped develop a close relationship between many chiropractors and dentists. The objective is to find the reason why the body is not a self-correcting, self-maintaining mechanism so the patient can return to health.

Therapy localization to the injured TM Joint
will produce immediate weakening in a
previously strong indicator muscle
anywhere in the body. (BELOW)




"In reviewing the literature, the subject of functional relations between voluntary muscles and dural membranes has been addressed by Becker (1983), who suggests that the voluntary muscles might act upon the dural membranes via fascial continuity, changing the tension placed upon them, thus possibly influencing CSF pressure."
-- Upledger & Vredevoogd, 1983 

One of the most influential books on cranial therapy
ever written was by Dr. David S. Walther --
Founder of the Chiropractic Health Center, PC --
in Pueblo Colorado.
 



The importance of precision in cranial treatments
cannot be over-emphasized. The number of angles
within the cranial sutures, and the intimate investment
of these angles and surfaces by the most important
nerves in the body, must be appreciated.
The AK approach to the diagnosis of
cranial problems makes the detection
of these factors available to the clinician.

 
Two new textbooks (bringing AK into the era of Evidence-Based Medicine)
are available now -- the 2nd editions of these books IN COLOR!
 
 
 
 

 

Order Today!



REFERENCES
Symptomatic Arnold-Chiari malformation and cranial nerve dysfunction: a case study of applied kinesiology cranial evaluation and treatment. J Manipulative Physiol Ther. 2005 May;28(4):e1-6. http://www.ncbi.nlm.nih.gov/pubmed?term=Symptomatic%20Arnold-Chiari%20malformation%20and%20cranial%20nerve%20dysfunction%3A%20a%20case%20study%20of%20applied%20kinesiology%20cranial%20evaluation%20and%20treatment.%20.
  • Silverman MM. Effect of Skull Distortion on Occlusal Equilibration. Journal of Prosthetic Dentistry. April 1973
  • Stallard RE, Ravins HE. The Use of Sound in Adjusting Dental Occlusion. Quintessence International. June 1976;6. 
  • Upledger JE, Vredevoogd JD. Craniosacral Therapy. Eastland Press: Seattle;1983.

  • Sunday, July 17, 2011

    Dr. Shaun Craig joins Chiropractic Health Center's Team in Pueblo, Colorado


    The Chiropractic Health Center is proud to welcome

    Dr. Shaun Craig to Pueblo!

    Dr. Shaun Craig

     

    Originally from North Dakota, Dr. Craig has relocated to Pueblo Colorado after many years of chiropractic practice. Dr. Craig is dedicated to finding natural health solutions for his patients utilizing applied kinesiology chiropractic methods, in which he is a trained and certified practitioner.


    Dr. Craig welcomes new patients and Medicare

     

    Characteristics of Applied Kinesiology 

    at the Chiropractic Health Center

    719-544-1468



    ·        Correlates with and enhances standard examination.

    ·        Diagnoses and treats the primary finding in cases of neuromusculoskeletal dysfunction, i.e. muscle impairment and inhibition.

    ·        Adds extra patient specific information to the standard history, physical diagnosis, and laboratory tests.

    ·        Helps the doctor to understand functional symptomatic complexes when standard diagnosis and laboratory tests show no cause for the symptoms.

    ·        Examines all sides of the triad of health. (See image below)


    Triad of Health
    Treatment to each side of the triangle is possible
    with Applied Kinesiology methods.

    ·        Assesses body control by the nervous system.


    ·        Integrates function of the meridian system (acupuncture) into the examination.


    ·        Examines function before symptoms are present in order to prevent or delay the onset of pathologic processes.


    ·        Interdisciplinary approach – fits the best treatment to the patient’s specific needs.


    ·        Provides an interactive assessment of an individual’s functional health status that is non-invasive and comparatively inexpensive and emphasizes the importance of correlating findings with standard diagnostic procedures.

     

    Applied Kinesiology Chiropractic Technique: Rationale, Science and Evidence


    --by Dr. Scott Cuthbert (Owner, Chiropractic Health Center, PC)

    Introduction

    Applied Kinesiology (AK) draws together the core elements of many chiropractic methods and other complementary and alternative medicine (C.A.M.) systems. AK practitioners understand that muscle inhibition is a major diagnostic expression of neuro- musculoskeletal dysfunction and have the option to use a variety of alternative disciplines in the treatment of the patient. The assessment of the functional status of the patient is the major focus it offers to traditional medical care. Using changes in the manual muscle test (MMT) as a diagnostic process unites the various C.A.M. systems within AK.



    Figure 1. Abnormal results of the manual muscle test, whether the muscle is weak or hypertonic, may indicate abnormal involvement of any of the factors surrounding it. A change in muscle function when specific stimulation or therapy is applied to one of these elements also indicates dysfunction of the surrounding factors.

    Sufferers gain relief from their headaches by visiting a chiropractor, improve their allergies by seeing an acupuncturist, or lose weight with the help of a nutritionist. The AK practitioner utilizes all these alternative techniques and integrates them with standard diagnostic tests as well as the MMT; therefore patients are not limited to just one diagnostic method or one means of treatment. There is no other clinical method available for testing specific muscle strength and function as reliable, easy-to-use, inexpensive and valid as the manual muscle test (MMT). [1-2]

    AK provides an integrated, interdisciplinary approach to health care. George J. Goodheart, D.C., originated AK in 1964. Dr. Goodheart found a technique that could immediately make a muscle that tested weak strong. The technique did not correct all muscles that tested weak but from this initial experience, testing muscles in a precise manner became routine in his examination protocol. The investigation of other causes of muscle weakness and their correction developed into what is currently the practice of AK.

    Goodheart’s work drew a large following of doctors and recognition. He was the first chiropractor officially appointed to the US Winter Olympic Sports Medicine team. [3] In 1976 the International College of Applied Kinesiology was founded to promote the research and teaching of AK. [2]

    The ICAK began in the United States with a majority of chiropractors as members.  There are now chapters in Australia, Austria, Benelux, Brazil, Canada, France, Germany, Italy, Korea, Russia, Sweden, Switzerland, United Kingdom, and the USA. The organization is multi-disciplinary; membership includes medical doctors, osteopaths, dentists, psychologists, and other health care providers who are licensed to diagnose patients. Medical practitioners using AK vary by country.  There are nearly 1,000 medical doctors in Germany, for instance, who use AK as part of their diagnostic system. [4]

    The first book to describe the value of AK to other professions -- "AK and the Stomatognathic System" -- was authored by Gelb, a dentist, in 1977. [5]

    Goodheart set the peer review trend for AK by publishing a discussion of dentistry and AK in 1976. [6] Scopp published the first research paper discussing the AK approach to a functional organic disorder with allergy testing in 1979. [7]

    There are now over 100 papers published in peer-reviewed journals on the methods and outcomes of AK. [2] Few chiropractic therapeutic methods have been investigated or written about as extensively as AK. There have been 35 separate books published about AK methods since 1964. [2]

    American Chiropractic Association Statement on AK

    According to the American Chiropractic Association, Applied Kinesiology is one of the  most frequently used chiropractic techniques in the United States, with 43.2% of chiropractors employing this method.

    "This is an approach to chiropractic treatment in which several specific procedures may be combined. Diversified/manipulative adjusting techniques may be used with nutritional interventions, together with light massage of various points referred to as neurolymphatic and neurovascular points. Clinical decision-making is often based on testing and evaluation of muscle strength." [8]

    Science and AK

    Several websites now display each of the Index Medicus peer-reviewed research papers (including their Abstracts) regarding applied kinesiology and the reliability and validity of the manual muscle test. These papers go from 1915 (Journal of the American Medical Association, with a paper called "A method of testing muscular strength in infantile paralysis" by Martin EG, and Lovett RW), through research reports up to 2008 in publications like the Journal of Manipulative and Physiological Therapeutics, Physical Therapy, and the Journal of Electromyography and Kinesiology. This is the most comprehensive coverage of the research literature substantiating applied kinesiology methods ever published. [2]
    Evidence-based decision making in clinical practice requires, first of all, evidence. This research offers evidence about the methods, clinical efficacy, and neurologic rationales of applied kinesiology examination and treatment. [9-10]

    The research and reviews of applied kinesiology are listed at the National Library of Medicine, where AK research has now been given its own MESH heading. [11]

    For at least 50 years it has been thought that most forms of chronic musculoskeletal pain are due to abnormal patterns of muscular activity. However, after 50 years the research evidence is suggesting the demise of the hyperactivity-causality model for musculoskeletal pain. The lack of convincing evidence to support the belief in hyperactivity as the etiological factor in musculoskeletal conditions has been pointed out in recent reviews of the literature for many chronic musculoskeletal disorders. [12-14]

    For chiropractors and other manipulative or orthopedic physicians, the importance of expertly assessing the functional state of the motor system is emphasized by studies suggesting that faulty motor control is the most likely source of at least 50% of low back pain syndromes. [15]

    The evidence now shows with greater clarity than ever before that inflammation or injury produces specifically identified inhibited muscles. Controlled clinical studies have shown that dysfunction and pain specifically in the ankle, [16] knee, [17-19] lumbar spine, [20-22] temporomandibular joint, [23] and cervical spine [24-27] will produce inhibited muscles. These data indicate that the body’s reaction to injury and pain is not increased muscular tension and stiffness; rather muscle inhibition is often more significant. These results are more in line with the common impression that pain makes muscles difficult to use and less powerful. [28]

    Because of Sherrington’s Law of Reciprocal Inhibition, these two functional states in muscles are related. [29] Sherrington’s law states that decreased activity of certain muscles leads to facilitation – and thus increased activity and tension – of their antagonist muscles. Poor motor control goes hand in hand with decreased joint stability and may be the fundamental force creating and perpetuating spinal dysfunction. [30-39]

    Muscles not only move bones, they hold the skeletal system in balance. There is a dynamic tension in the musculoskeletal system. The muscles act like guy wires holding the bones in place. Skeletal balance is maintained by opposing muscles. If a muscle is weaker than the one opposing it, the opposing muscle becomes tight and the skeletal structures will be out of balance.

    










    Figure 2: Muscle Balance                               Balance lost from weak muscle

    A weak muscle can cause pain and spasm in the opposing muscle. Ironically many therapeutic efforts are directed toward spastic muscles, which are not the cause of the problem. For example, weak abdominal muscles will cause the pelvis to tilt and the antagonistic low back muscles to go into spasm. Until the weakness in the abdominal muscles is corrected, efforts to reduce the spasm in the low back will not be very effective.

    The later works of Panjabi, Janda, Lewit, Jull, Sahrmann, Bergmark, Hammer and Liebenson have confirmed the original findings of Goodheart, reporting that muscles predictably respond to pain, inflammation, and/or injury with weakness. [30-39] These researchers have demonstrated that functional pathology of the muscle system is the most common clinical finding in pain patients presenting to chiropractors and other musculoskeletal physicians. However, this disorder of the muscle system is routinely ignored in the diagnosis and treatment of these patients because physicians do not have a tool to diagnose it.

    The MMT presents a clinical strategy to assess these muscular impairments that have been shown to drive so many of the clinical conditions affecting chiropractic patients.

    The muscle weakness revolution that is now occurring in the scientific literature requires the use of clinical tools like the MMT that are uniquely designed to detect this important neuromuscular impairment in the patients that chiropractors, orthopedists, rheumatologists, physical therapists, dentists, and general practitioners treat. The ICAK has been training doctors of chiropractic in the precise methodologies of MMT for over 30 years, and if physicians are not capable of diagnosing this problem in patients, they are missing a fundamental component of their musculoskeletal dysfunction.
    Assessing the function of muscles with the MMT pre- and post-treatment can also assess the benefit of a therapeutic intervention: does the therapy improve or worsen muscle function?  This assessment process is the basis of applied kinesiology (AK).

    A recent paper (Chiropractic Muscle Testers Rise to the Challenge of Validating Their Work) has described the research evidence behind the chiropractic profession’s use of the MMT. [40]


    Basic applied kinesiology


    AK uses standard manual muscle testing as a diagnostic method for evaluating the body’s health. Commonly, AK patients have their muscles tested in many different functional positions.

    Through evaluation of the function of specific muscles pre- and post-treatment throughout a patient's body, therapeutic efficacy for particular problems can be evaluated. Applied kinesiologists theorize that physical, chemical, and mental imbalances are associated with secondary muscle dysfunction – specifically a muscle inhibition (usually preceding an overfacilitation of an opposing muscle).

    Challenge is an essential diagnostic procedure used to determine the body’s ability to cope with external stimuli, which can be physical, chemical, or mental.  An example of a physical stimulus is pushing on an articulation to determine if there is a muscle strength change. Chemical stimulus may occur when one inhales potentially toxic chemicals or chews nutritional factors.  Mental stimuli include thought processes, either pleasant or unpleasant to the individual. After an external stimulus is applied, muscle-testing procedures are done to determine an improvement in or weakening of the muscle strength as a result of the stimulus.

    Therapy localization is another diagnostic procedure in AK that consists of placing the patient’s hand over areas of suspected involvement, then using muscle testing procedures to determine any change in strength. Placing the patient’s hand on different locations stimulates nerve endings and/or possibly changes the patient’s electromagnetic energy field. Therapy localization is strictly a diagnostic tool in AK that is to be combined with the other diagnostic findings to arrive at a final conclusion.

    Applying the proper therapy results in an immediate strengthening of the inhibited muscle. Scientific, repeatable, and accurate muscle testing requires the specific maximum isolation of a muscle before it is tested. The MMT should evaluate individual muscles as far as possible. There is an overlap of muscle actions, as well as an interdependence of muscles in movement. This close relationship in muscle function need not rule out the possibility or the practicability of testing individual muscles. There is an ideal starting position and vector of testing force that places the muscle being tested as the prime mover and the synergists at a disadvantage. When any one muscle in the body is inhibited in its strength or action, stability of the part is impaired or some exact movement is lost to some extent.



    Figure 3 demonstrates MMT of the psoas major muscle. It shows that the quadriceps, sartorius, and adductor muscles all assist in holding the hip in a flexion position. However, the line of pull of the muscle and the direction of the examiner’s pressure place emphasis on the action of the right psoas major, making identification of inhibition in this specific muscle possible.




    Figure 4. Synergist muscle substitution can be identified and prevented during the MMT. In this figure (demonstrating a gluteus maximus muscle test), the examiner can visualize a lifting of the pelvis with external rotation and abduction of the hip, with recruitment of the ipsilateral hamstring, thoracolumbar extensors, and contralateral leg flexor muscles. The pelvis externally rotates because the weak gluteus maximus recruits synergists to facilitate its action during the MMT.

    The arm-pull-down test (commonly used by novice muscle testers and by the critics of AK methods) is considered by the International College of Applied Kinesiology (ICAK) to be a very poor form of muscle testing. The arm-pull-down test involves so many different muscles that no specificity as to the muscle with the problem and the neurological factors associated with a positive muscle test findings can be ascertained upon testing a muscle this way.


    Figure 5. The “arm test” does not isolate nor specifically test any particular shoulder muscle.

    Nutritional evaluation in AK is done as part of a total examination. A muscle test alone is inadequate to determine nutritional needs. From its beginning the ICAK has taught that all muscle tests must confirm the findings of laboratory, nutritional diaries, blood and saliva testing, and patient history. A person who uses one MMT to determine the nutritional status of a patient has in fact misunderstood AK and is ignoring the criteria set down by the ICAK. For chiropractors, the dietary and nutritional factor is only one component of the problem posed by a particular patient.

    AK nutrient testing appears to reflect the nervous system's efferent response to the stimulation of gustatory and olfactory nerve receptors by various tested substances. There is considerable evidence in the scientific literature of extensive efferent function throughout the body from stimulation of the gustatory and olfactory receptors.

    The taste receptors on the tongue can detect very small concentrations of substances within a fraction of a second. [41] Exposure to taste elicits a variety of immediate responses throughout the body, including neurological, digestive, endocrine, cardiovascular, thermogenic, and renal. [42]

    Evaluation of nutritional products and foods by determining how your body reacts to them, as observed by MMT, is an important addition to providing optimal nutritional support to patients who need it.

    External links

    Summary

    Much of the subjectivity in manual medicine (motion palpation, cranio-sacral palpation, pulse-diagnosis, the examiner's sense of the tissues, and postural analysis) has been made more objective by the use of manual muscle testing. The findings of various manual medicine modalities (when evaluated using manual muscle testing) have been placed into the scientific arena...scientific in the practical sense meaning that which is explicable, measurable, demonstrable, and reproducible.

    There is an approach to health care that helps the doctor understand functional conditions and provides direction toward the optimal treatment. It is the functional examination that includes applied kinesiology assessment.

    References:

    1)       Cuthbert SC, Goodheart GJ Jr. On the reliability and validity of manual muscle testing: a literature review, Chiropr Osteopat. 2007 Mar 6;15(1):4. Available at: http://www.chiroandosteo.com/content/15/1/4.
    2)       ICAK-USA and ICAK-International websites: “AK Research Compendium. Dr. Scott Cuthbert, 9-16-2007http://www.icakusa.com/scientificresearch.php and http://www.icak.com/college/research/publishedarticles.shtml.  Accessed July 29, 2008.
    6)       Goodheart, GJ, Jr. 1976. Kinesiology and Dentistry.  J Amer Soc Psychosomatic Disease  6:16-18.
    7)       Scopp A. 1979. An Experimental Evaluation of Kinesiology in Allergy and Deficiency Disease Diagnosis. Journal of Orthomolecular Psychiatry. 7(2):137-8.
    9)       Expanding the neurological examination, Part 1. Intern. J. Neuroscience. http://www.icakusa.com/upload/files/Intern%20J%20Neuroscience%201999%20Expanding%20the%20Neurological%20Exam%20Part%201%20of%202.pdf.
    12)   Lund JP. et al.  The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity, Canadian Journal of Physiology and Pharmacology, 1991;69:683-694.
    13)   Dishman JD, Greco DS, Burke JR. Motor-evoked potentials recorded from lumbar erector spinae muscles: a study of corticospinal excitability changes associated with spinal manipulation. J Manipulative Physiol Ther. 2008 May;31(4):258-70.
    14)   Fryer G, Morris T, Gibbons P. Paraspinal muscles and intervertebral dysfunction: part two. J Manip Physiol Ther. 2004 Jun;27(5):348-57.
    15)   Mannion AF, Junge A, Taimela S, M√ľntener M, Lorenzo K, Dvorak J. Active therapy for chronic low back pain: part 3. Factors influencing self-rated disability and its change following therapy. Spine. 2001 Apr 15;26(8):920-9.
    16)   Nicholas JA, Marino M: The relationship of injuries of the leg, foot, and ankle to proximal thigh strength in athletes, Foot Ankle. 1987 Feb;7(4):218-28.
    17)   Slemenda C, Brandt KD, Heilman DK, Mazzuca S, Braunstein EM, Katz BP, Wolinsky FD. Quadriceps weakness and osteoarthritis of the knee. Ann Intern Med. 1997 Jul 15;127(2):97-104.
    18)   Stokes M, Young A: Investigations of quadriceps inhibition: implications for clinical practice. Physiotherapy 1984;70:425-428.
    19)   Spencer JD, Hayes KC, Alexander IJ: Knee joint effusion and quadriceps reflex inhibition in man. Arch Phys Med Rehab 1984;65:171-177.
    20)   Nummi J, Jarvinen T, Stambej U, Wickstrom G: Diminished dynamic performance capacity of back and abdominal muscles in concrete reinforcement workers. Scand J Work Environ Health 1978, 4 Suppl 1:39-46.
    21)   Hodges PW, Richardson CA: Inefficient muscular stabilization of the lumbar spine associated with low back pain. Spine 1996, 21:2640-2650.
    22)   Hossain M, Nokes LDM: A model of dynamic sacro–iliac joint instability from malrecruitment of gluteus maximus and biceps femoris muscles resulting in low back pain. Medical Hypotheses 2005, 65(2):278-281.
    23)   Zafar H: Integrated jaw and neck function in man. Studies of mandibular and head-neck movements during jaw opening-closing tasks. Swed Dent J Suppl, 2000;(143):1-41.
    24)   Jull GA: Deep cervical flexor muscle dysfunction in whiplash. J Musculoskel Pain 2000;8:143-154.
    25)   Jull G, Barret C, Magee R, Ho P: Further clinical clarification of the muscle dysfunction in cervical headache. Cephalgia 1999; 19:179-185.
    26)   Vernon HT, Aker P, Aramenko M, Battershill D, Alepin A, Penner T: Evaluation of neck muscle strength with a modified sphygmomanometer dynamometer: reliability and validity. J Manipulative Physiol Ther. 1992 Jul-Aug;15(6):343-9.
    27)   Edgerton VR, Wolf SL, Levendowski DJ, Roy RR: Theoretical basis for patterning EMG amplitudes to assess muscle dysfunction. Med Sci Sp Exer 1996;28:744-751.
    28)   Mills KR, Edwards RH. Investigative strategies for muscle pain. J Neurol Sci. 1983 Jan;58(1):73-8.
    29)   Sherrington C: Selected Writings of Sir Charles Sherrington, Ed. Brown DD. Oxford: Oxford University Press; 1979:274-282.
    30)   Lewit K: Manipulative Therapy in Rehabilitation of the Locomotor System, 3rd ed. London: Butterworths; 1999.
    31)   Liebenson C. Ed: Rehabilitation of the Spine: A Practitioner’s Manual, 2nd ed. Philadelphia: Lippincott, Williams & Wilkins; 2007.
    32)   Janda V: Muscle Function Testing. London: Butterworths; 1983.
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    Scott C. Cuthbert, BA, DC


    A native of California, Dr. Scott Cuthbert first attended St. John’s College, where he received his BA in the liberal arts. Dr. Scott (as his patients call him) then graduated from the Palmer College of Chiropractic in Davenport, Iowa. He migrated to Ireland and practiced chiropractic on Finn MacCool’s island for two years. He came to study the applied kinesiology chiropractic of Dr. George Goodheart in 2000 and found within that study a lifetime’s work. Dr. Scott is on the board of directors of the International College of Applied Kinesiology (ICAK-USA), and is co-chairman of its research committee. He practices at the Chiropractic Health Center in Pueblo, Colorado and can be reached at (719) 544-1468 or via email at cranialdc@hotmail.com. His research can be reviewed at http://www.icakusa.com/.